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. 2017 Aug 10;12(8):e0182596.
doi: 10.1371/journal.pone.0182596. eCollection 2017.

Therapeutic response assessment using 3D ultrasound for hepatic metastasis from colorectal cancer: Application of a personalized, 3D-printed tumor model using CT images

Ye Ra Choi  1 , Jung Hoon Kim  2   3 , Sang Joon Park  4 , Bo Yun Hur  5 , Joon Koo Han  2   3
Affiliations

Therapeutic response assessment using 3D ultrasound for hepatic metastasis from colorectal cancer: Application of a personalized, 3D-printed tumor model using CT images

Ye Ra Choi et al. PLoS One. .

Abstract

Background & aims: To evaluate accuracy and reliability of three-dimensional ultrasound (3D US) for response evaluation of hepatic metastasis from colorectal cancer (CRC) using a personalized 3D-printed tumor model.

Methods: Twenty patients with liver metastasis from CRC who underwent baseline and after chemotherapy CT, were retrospectively included. Personalized 3D-printed tumor models using CT were fabricated. Two radiologists measured volume of each 3D printing model using 3D US. With CT as a reference, we compared difference between CT and US tumor volume. The response evaluation was based on Response Evaluation Criteria in Solid Tumors (RECIST) criteria.

Results: 3D US tumor volume showed no significant difference from CT volume (7.18 ± 5.44 mL, 8.31 ± 6.32 mL vs 7.42 ± 5.76 mL in CT, p>0.05). 3D US provided a high correlation coefficient with CT (r = 0.953, r = 0.97) as well as a high inter-observer intraclass correlation (0.978; 0.958-0.988). Regarding response, 3D US was in agreement with CT in 17 and 18 out of 20 patients for observer 1 and 2 with excellent agreement (κ = 0.961).

Conclusions: 3D US tumor volume using a personalized 3D-printed model is an accurate and reliable method for the response evaluation in comparison with CT tumor volume.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flowchart of patient selection and phantom construction.
Fig 2
Fig 2. Study process flowsheet.
A) Screenshot of the in-house program of segmentation and 3-dimensional volume-rendering reconstruction of the tumor. B) A personalized 3D-printed phantom tumor model constructed by the software and 3D printer. We had irereguler shaped 3D-printed phantom tumor model using the baseline CT and post-chemotherapy CT images in both response and non-response groups. C) Experimental setting for sonographic volume measurement of the phantom using 3D-transducer scanning through an automated sweeping movement. D) Volume measurement of the phantom. Manual outlining of the boundaries of the tumor phantom at 8 images of transverse (upper left) or longitudinal (upper right) plane. Then, boundaries at coronal plane (lower left) and 3D reconstructed image and its volume (lower right) were automatically generated by the built-in software of the ultrasound unit.
Fig 3
Fig 3. Comparison of measured volume using three-dimensional ultrasound and estimated volume from 2D diameters (V=π6abc) with the true volume of tumor phantoms.
A-C) Plots of difference between the volume measurement and estimation against the true volume. The 95% limits of agreement (mean difference ± 1.96 SD) calculated using the Bland and Altman method were indicated as dashed line.
See this image and copyright information in PMC

References

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